ArticlePLoS medicine2020
Association between prehospital time and outcome of trauma patients in 4 Asian countries: A cross-national, multicenter cohort study.
Article in PLoS medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.
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Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition.Critical care (London, England) · 2023Guideline
- Impact of the emergency medical services crew size (2 vs. ≥3 personnel) on prehospital performance and survival in severe trauma: a nationwide cohort study in Korea.Journal of trauma and injury · 2026Article
- Future Directions and Evolution Strategies for the Clinical Management of Traumatic Brain Injury.Journal of clinical medicine · 2026Article
- Article
- The impact of advanced pre-hospital interventions on scene time.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- Association between prehospital time and mortality in severe trauma: a restricted cubic spline analysis from a physician-staffed helicopter emergency medical service.BMC emergency medicine · 2026Article
- Validation of a mobile application for prehospital transport time data collection in Kigali, Rwanda.BMC global and public health · 2026Article
- Telemedicine Devices in Prehospital Trauma Care: A Scoping Review of Telemedical Actions, Clinical Utilities and Implementation Barriers.Journal of medical systems · 2026Article
- Urban Environmental Determinants and Spatiotemporal Patterns of Emergency Medical Service Response to Traumatic Injuries: A Five-Year Population-Based Study.International journal of environmental research and public health · 2026Article
- Factors Associated with Prolonged Prehospital On-Site Time in Adult Trauma Patients: A Nationwide Observational Study in Japan.JMA journal · 2026Article
- Chinese expert consensus on the prehospital management of major trauma.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2026Article
- Cardiogenic Shock Systems of Care Best Practices. Part 1: Prehospital and Emergency Department Evaluation and Management.US cardiology · 2026Review
- Prehospital time intervals for trauma patients according to population density levels in Sweden; a national retrospective cohort study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Navigating Complex Maxillofacial Trauma: A Case Report on Arrow Shot Injury to the Face by a Speargun.Journal of acute medicine · 2025Article
- Effects of the medical professional shortage caused by a resident walkout on scene-to-door time: a retrospective cohort study at a trauma center.Journal of trauma and injury · 2025Article
- Impact of Delayed Trauma Unit Admission on Mortality and Disability in Traumatic Brain Injury Patients.International journal of environmental research and public health · 2025Observational
- Navigating Limitations and Clinical Challenges in Indonesian Tertiary Trauma Center for Penetrating Brain Injury: A Case Report and Literature Review.Asian journal of neurosurgery · 2025Article
- Factors Associated with the Utilization of Out-of-Region Medical Institutions for Brain Diseases.Yonsei medical journal · 2025Article
- Influence of on-scene time and prehospital interventions on inhospital mortality in trauma patients.BMC emergency medicine · 2025Article
- Impact of direct prehospital transport on mortality in patients with severe trauma based on the injury severity score: a nationwide observational study in the Republic of Korea.Osong public health and research perspectives · 2025Article
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Authors and funding
12 authors.
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Abstract
backgroundWhether rapid transportation can benefit patients with trauma remains controversial. We determined the association between prehospital time and outcome to explore the concept of the "golden hour" for injured patients. METHODS AND
findingsWe conducted a retrospective cohort study of trauma patients transported from the scene to hospitals by emergency medical service (EMS) from January 1, 2016, to November 30, 2018, using data from the Pan-Asia Trauma Outcomes Study (PATOS) database. Prehospital time intervals were categorized into response time (RT), scene to hospital time (SH), and total prehospital time (TPT). The outcomes were 30-day mortality and functional status at hospital discharge. Multivariable logistic regression was used to investigate the association of prehospital time and outcomes to adjust for factors including age, sex, mechanism and type of injury, Injury Severity Score (ISS), Revised Trauma Score (RTS), and prehospital interventions. Overall, 24,365 patients from 4 countries (645 patients from Japan, 16,476 patients from Korea, 5,358 patients from Malaysia, and 1,886 patients from Taiwan) were included in the analysis. Among included patients, the median age was 45 years (lower quartile [Q1]-upper quartile [Q3]: 25-62), and 15,498 (63.6%) patients were male. Median (Q1-Q3) RT, SH, and TPT were 20 (Q1-Q3: 12-39), 21 (Q1-Q3: 16-29), and 47 (Q1-Q3: 32-60) minutes, respectively. In all, 280 patients (1.1%) died within 30 days after injury. Prehospital time intervals were not associated with 30-day mortality. The adjusted odds ratios (aORs) per 10 minutes of RT, SH, and TPT were 0.99 (95% CI 0.92-1.06, p = 0.740), 1.08 (95% CI 1.00-1.17, p = 0.065), and 1.03 (95% CI 0.98-1.09, p = 0.236), respectively. However, long prehospital time was detrimental to functional survival. The aORs of RT, SH, and TPT per 10-minute delay were 1.06 (95% CI 1.04-1.08, p < 0.001), 1.05 (95% CI 1.01-1.08, p = 0.007), and 1.06 (95% CI 1.04-1.08, p < 0.001), respectively. The key limitation of our study is the missing data inherent to the retrospective design. Another major limitation is the aggregate nature of the data from different countries and unaccounted confounders such as in-hospital management.
conclusionsLonger prehospital time was not associated with an increased risk of 30-day mortality, but it may be associated with increased risk of poor functional outcomes in injured patients. This finding supports the concept of the "golden hour" for trauma patients during prehospital care in the countries studied.
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